Care for end-stage kidney disease in China: progress, challenges, and recommendations

Summary: This review comprehensively evaluates China’s progress in care of end-stage kidney disease (ESKD) by identifying achievements and gaps, reviewing ESKD-related policy initiatives, and proposing policy recommendations. In the past decade, China has made laudable progress in access to ESKD car...

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Main Authors: Tiange Chen, Xuefeng Sun, Sian Tsuei, Ruirui Yang, Winnie Yip, Hongqiao Fu
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:The Lancet Regional Health. Western Pacific
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666606524002621
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author Tiange Chen
Xuefeng Sun
Sian Tsuei
Ruirui Yang
Winnie Yip
Hongqiao Fu
author_facet Tiange Chen
Xuefeng Sun
Sian Tsuei
Ruirui Yang
Winnie Yip
Hongqiao Fu
author_sort Tiange Chen
collection DOAJ
description Summary: This review comprehensively evaluates China’s progress in care of end-stage kidney disease (ESKD) by identifying achievements and gaps, reviewing ESKD-related policy initiatives, and proposing policy recommendations. In the past decade, China has made laudable progress in access to ESKD care with narrowed difference between the number of patients needing and receiving kidney replacement therapies (KRT). China has also experienced significant improvements in clinical quality and outcomes of ESKD care. These achievements stem from concerted efforts in advocating effective policies, increasing fiscal subsidies, re-designing health insurance schemes, encouraging healthcare delivery from both public and private sectors, and improving quality regulation. However, challenges remain, including inequitable access to care across regions and groups, and suboptimal quality and outcomes in some underdeveloped areas. To address these gaps, we recommend reforming the financing policy, adopting quality-based payment methods, strengthening quality monitoring system, improving chronic kidney disease prevention and management, and developing alternative KRT modalities.
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series The Lancet Regional Health. Western Pacific
spelling doaj-art-ff71daf07e0846efa252b464278607452025-08-20T01:57:11ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-01-015410126810.1016/j.lanwpc.2024.101268Care for end-stage kidney disease in China: progress, challenges, and recommendationsTiange Chen0Xuefeng Sun1Sian Tsuei2Ruirui Yang3Winnie Yip4Hongqiao Fu5School of Public Health, Peking University Health Center, Beijing, ChinaDepartment of Nephrology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China; State Key Laboratory of Kidney Diseases, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China; National Clinical Research Center for Kidney Diseases, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, ChinaDepartment of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, CanadaSchool of Public Health, Peking University Health Center, Beijing, ChinaDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USASchool of Public Health, Peking University Health Center, Beijing, China; Corresponding author. Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing 100191, China.Summary: This review comprehensively evaluates China’s progress in care of end-stage kidney disease (ESKD) by identifying achievements and gaps, reviewing ESKD-related policy initiatives, and proposing policy recommendations. In the past decade, China has made laudable progress in access to ESKD care with narrowed difference between the number of patients needing and receiving kidney replacement therapies (KRT). China has also experienced significant improvements in clinical quality and outcomes of ESKD care. These achievements stem from concerted efforts in advocating effective policies, increasing fiscal subsidies, re-designing health insurance schemes, encouraging healthcare delivery from both public and private sectors, and improving quality regulation. However, challenges remain, including inequitable access to care across regions and groups, and suboptimal quality and outcomes in some underdeveloped areas. To address these gaps, we recommend reforming the financing policy, adopting quality-based payment methods, strengthening quality monitoring system, improving chronic kidney disease prevention and management, and developing alternative KRT modalities.http://www.sciencedirect.com/science/article/pii/S2666606524002621End-stage kidney diseaseKidney replacement therapyAccessQuality and outcomeHealth policyChina
spellingShingle Tiange Chen
Xuefeng Sun
Sian Tsuei
Ruirui Yang
Winnie Yip
Hongqiao Fu
Care for end-stage kidney disease in China: progress, challenges, and recommendations
The Lancet Regional Health. Western Pacific
End-stage kidney disease
Kidney replacement therapy
Access
Quality and outcome
Health policy
China
title Care for end-stage kidney disease in China: progress, challenges, and recommendations
title_full Care for end-stage kidney disease in China: progress, challenges, and recommendations
title_fullStr Care for end-stage kidney disease in China: progress, challenges, and recommendations
title_full_unstemmed Care for end-stage kidney disease in China: progress, challenges, and recommendations
title_short Care for end-stage kidney disease in China: progress, challenges, and recommendations
title_sort care for end stage kidney disease in china progress challenges and recommendations
topic End-stage kidney disease
Kidney replacement therapy
Access
Quality and outcome
Health policy
China
url http://www.sciencedirect.com/science/article/pii/S2666606524002621
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AT ruiruiyang careforendstagekidneydiseaseinchinaprogresschallengesandrecommendations
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